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The Total Iron Binding Capacity test measures the ability of your blood to bind and transport iron, and therefore reflects your body's iron stores. TIBC correlates with the amount of transferrin, a protein, in your blood, that helps bind iron and facilitates its transportation in the blood. Usually, about one-third of the transferrin measured is being used to transport iron, and this is called transferrin saturation.

An Iron, Serum test determines iron levels in the blood and can help diagnose conditions like anemia, or iron overload in the body. People usually suffer from low iron levels in the blood if they prefer a diet that has low iron content, or if their body has trouble absorbing the iron from the foods or supplements they intake. Low iron levels can also occur due to intense blood loss or even during pregnancy. Similarly, an excess amount of iron in the blood can occur due to over-intake of iron supplements, blood transfusions, or if you are suffering from a condition called hemochromatosis (a rare genetic disorder that causes too much iron to build up in the body or cause problems in the body to remove excess iron). 

Therefore, doctors often suggest an Iron, Serum to help check the status of your iron level, get valuable information about your nutritional well-being, detect potential health issues (if any), and take timely preventive measures.

An Unsaturated Iron Binding Capacity test determines the reserve capacity of transferrin, i.e., the portion not yet saturated with iron. The iron-binding capacity of our body can be segregated into two parts – Total Iron Binding Capacity (TIBC) and Unsaturated Iron Binding Capacity (UIBC). UIBC refers to the capacity of transferrin, a protein that transports iron, to bind with additional iron. In easy terms, it represents the available "slots" on transferrin to carry iron molecules. Unlike iron saturation, which assesses the occupied slots, UIBC measures the unoccupied ones.

The Transferrin Saturation test determines an individual’s iron status by using the ratio of serum iron concentration and total iron binding capacity (TIBC) as a percentage. The test tells us how much iron in the blood is bound to transferrin, the main protein in the blood that binds to iron and transports it throughout the body. Under normal conditions, transferrin is one-third saturated with iron, so about two-thirds of its capacity is held in reserve. This test is often employed alongside others to evaluate iron levels and diagnose conditions like iron deficiency anemia if transferrin saturation is low or hemochromatosis (an iron overload disorder) if transferrin saturation is higher than normal.

An ESR test measures the rate at which red blood cells (erythrocytes) settle (sediment) in one hour at the bottom of a tube that contains a blood sample.

When there is inflammation in the body, certain proteins, mainly fibrinogen, increase in the blood. This increased amount of fibrinogen causes the red blood cells to form a stack (rouleaux formation) that settles quickly due to its high density, leading to an increase in the ESR.

An ESR test is a non-specific measure of inflammation and can be affected by conditions other than inflammation. This test cannot identify the exact location of the inflammation in your body or what is causing it. Hence, an ESR test is usually performed along with a few other tests to identify or treat possible health concerns.

The CBC (Complete Blood Count) test measures the number of red blood cells (RBCs), white blood cells (WBCs), and platelets. Each of these blood cells performs essential functions–RBCs carry oxygen from your lungs to the various body parts, WBCs help fight infections and other diseases, and platelets help your blood to clot. Therefore, determining their levels can provide significant health information. A CBC test also determines the hemoglobin level, a protein in RBC that carries oxygen from the lungs to the rest of your body. Evaluating all these components together can provide important information about your overall health.

Gamma-Glutamyl Transferase (GGT) is an enzyme found in various organs, with the highest concentration in the liver. Usually, this enzyme is present in low levels in the blood. However, when there is liver damage or disease, GGT is released into the bloodstream, causing an increase in GGT levels. In addition to the liver, GGT can also be elevated in conditions affecting the bile ducts or the pancreas. It is usually, the first liver enzyme to rise in the blood when there is any damage or obstruction in the bile duct, making it one of the most sensitive liver enzyme tests for detecting bile duct problems.

An SGPT (Alanine Transaminase) test measures the amount of alanine transaminase (ALT) or SGPT enzyme in your blood. ALT is most abundantly found in the liver but is also present in smaller amounts in other organs like the kidneys, heart, and muscles. Its primary function is to convert food into energy. It also speeds up chemical reactions in the body. These chemical reactions include the production of bile and substances that help your blood clot, break down food and toxins, and fight off an infection.

Elevated levels of ALT in the blood may indicate liver damage or injury. When the liver cells are damaged, they release ALT into the bloodstream, causing an increase in ALT levels. Therefore, the SGPT/ALT test is primarily used to assess the liver's health and to detect liver-related problems such as hepatitis, fatty liver disease, cirrhosis, or other liver disorders.

An Alkaline Phosphatase (ALP) test measures the quantity of ALP enzyme present throughout the body. The main sources of this enzyme are the liver and bones. It exists in different forms depending on where it originates, such as liver ALP, bone ALP, and intestinal ALP. In the liver, it is found on the edges of the cells that join together to form bile ducts. 

ALP levels can be increased during pregnancy as it is found in the placenta of pregnant women. It is also higher in children because their bones are in the growth phase. ALP is often high during growth spurts (a short period when an individual experiences quick physical growth in height and body weight).

An SGOT (Aspartate Aminotransferase) test measures the levels of serum glutamic-oxaloacetic transaminase (SGOT), also known as aspartate aminotransferase (AST), an enzyme produced by the liver. SGOT is present in most body cells, most abundantly in the liver and heart. The primary function of this enzyme is to convert food into glycogen (a form of glucose), which is stored in the cells, primarily the liver. The body uses this glycogen to generate energy for various body functions.

The Protein Total, Serum test measures the amount of proteins in the body. Proteins are known as the building blocks of all cells and tissues. They play a crucial role in the growth and development of most of your organs and in making enzymes and hormones. There are two types of proteins found in the body, namely albumin and globulin. About 60% of the total protein is made up of albumin, which is produced by the liver. It helps to carry small molecules such as hormones, minerals, and medicines throughout the body. It also serves as a source of amino acids for tissue metabolism. On the other hand, globulin is a group of proteins that are made by the liver and the immune system. They play an important role in liver functioning, blood clotting, and fighting off infections.

The Bilirubin (Total, Direct and Indirect) test measures the level of three forms of bilirubin such as total bilirubin, direct (conjugated bilirubin), and indirect (unconjugated) bilirubin in the blood. Total bilirubin represents the sum of direct and indirect bilirubin. Direct bilirubin is the water-soluble form of bilirubin that has been processed by the liver via a conjugation process with glucuronic acid and is ready to be excreted into the bile ducts and ultimately into the intestines. Indirect bilirubin is the water-insoluble form of bilirubin that has not yet been processed by the liver and is bound to albumin in the blood. It is formed in the spleen and liver during the breakdown of hemoglobin from old or damaged red blood cells and cannot be excreted directly by the liver. Instead, it is transported to the liver, where it undergoes conjugation to become direct bilirubin. 

Getting tested with the Bilirubin (Total, Direct and Indirect) test provides valuable information into various aspects of liver function, bile duct health, and the body’s ability to break down and eliminate bilirubin.

The Thyroxine - Total (T4) test measures both the bound and unbound/free form of thyroxine (T4) hormone in the blood. T4 exists in the blood in two forms: bound (attached to proteins) and free (not attached to proteins). Most of the T4 circulating in the blood is bound to proteins and only a small part is free. It is necessary to maintain a fine balance of these forms to ensure the proper functioning of the body.

The Triiodothyronine - Total (T3) test measures triiodothyronine, also known as T3, hormone that is produced by the thyroid gland. T3 hormone plays an important role in regulating the body's metabolism, energy levels, and growth & development. It exists in the blood in two forms: free T3 and bound T3. Free T3 is not bound to proteins in the blood and is the active form of T3. Whereas, bound T3 is bound to proteins, such as albumin and thyroid hormone binding globulin (THBG), which prevent it from entering the body tissues.

The TSH (Thyroid Stimulating Hormone) Ultrasensitive test measures the levels of TSH hormone in the blood. TSH is produced by the pituitary gland located in the brain. Its function is to stimulate and regulate the functioning of the thyroid gland. It signals the thyroid gland to increase or decrease the production of thyroid hormones T3 and T4 when their levels are low or high, respectively. Therefore, when the levels of T3 & T4 decrease, the pituitary gland is stimulated to release TSH. This high TSH level, in turn, stimulates the thyroid gland to release more thyroid hormones (T3 & T4); vice versa happens when the levels of thyroid hormones increase.

The Serum Creatinine test measures the creatinine level, a byproduct produced by the wear and tear of muscles during energy production. Since kidneys help filter creatinine, this test helps determine how well your kidneys work. Usually, high levels of creatinine in the blood signal diminished kidney function. At the same time, low levels may indicate decreased muscle mass.

What Do the Results Mean?

Pathological Factors 

Key: ⇧: Indicates High Levels , ⇩: Indicates Low Levels

Physiological Factors

🧒 Age: Creatinine levels may decrease with age (due to reduction in muscle mass).

🫄 Pregnancy: Slightly lower levels can be seen due to physiological changes in kidney function during pregnancy.

Lifestyle Factors

🥗 Diet: High protein intake may transiently increase creatinine.

🏋️ Exercise: Intense physical activity can temporarily elevate creatinine levels.

💊 Medications: Some medicines, such as NSAIDs, antibiotics, or certain blood pressure medications, may influence kidney function and creatinine levels.

Disclaimer: This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalized guidance.

What Do Normal Serum Creatinine Levels Mean?

Normal serum creatinine levels indicate that the kidneys are functioning properly and effectively filtering waste products from the blood.

What Do High Levels of Serum Creatinine Indicate?

High serum creatinine may indicate impaired kidney function, dehydration, urinary tract obstruction, or other conditions affecting renal health.

What to Do if Your Serum Creatinine Is Higher Than Normal?

If your creatinine level is higher than normal, consult your doctor for proper guidance. They may recommend additional tests, lifestyle adjustments, medication review, or referral to a nephrologist.

What Do Low Levels of Serum Creatinine Indicate?

Low levels are uncommon but may indicate low muscle mass, malnutrition, or liver disease. Always discuss results with your healthcare provider.

Can Serum Creatinine Results Be Inaccurate?

Yes, serum creatinine results can sometimes be inaccurate. Factors such as severe muscle loss, certain medications or supplements, and variations or errors in laboratory test methodologies can affect the accuracy of the results.

What Factors Can Affect Serum Creatinine Results?

Though a reliable test, several factors can influence accuracy:

• Muscle mass, age, sex
• Diet, hydration status
• Medications affecting kidney function
• Severe illness or trauma
• Hyperbilirubinemia

What Follow-Up Tests May Be Required?

Depending on your serum creatinine results, your doctor may recommend additional tests to get a clearer picture of kidney health. These can include urine tests, such as urine protein or microalbumin or cystatin C, to detect early kidney damage; an eGFR calculation to estimate kidney filtration efficiency; kidney imaging, like an ultrasound, to check for structural abnormalities; and electrolyte or kidney function panels to assess overall kidney performance and detect any imbalances. Fasting is not recommended for this test, you can eat and drink as per your daily routine.

Table: Tests Commonly Ordered Alongside the Serum Creatinine Test

The Uric Acid, Serum test measures the amount of uric acid in your blood. Uric acid is a waste product formed when the body breaks down purines. Purines are the natural substances found in your body’s cells (DNA) and in certain foods like red meat, or seafood. Under normal conditions, uric acid dissolves in the blood, passes through the kidneys, and is excreted in the urine. When this process doesn’t work properly, either due to increased production or reduced elimination, the uric acid can build up in the blood. This may indicate underlying health issues such as kidney dysfunction, gout, or presence of kidney stones. In some cases, the exact reason for high uric acid levels is unclear. On the other hand, low uric acid levels are rarely a cause for concern. This test helps doctors understand if uric acid levels are within a healthy range and whether further evaluation or treatment is needed.

The Blood Urea Nitrogen test measures the levels of urea nitrogen in the blood. Blood urea is a waste product that is formed in the liver when you eat food and the protein is metabolized into amino acids. This process leads to the production of ammonia that is further converted into urea. Both ammonia and urea are nitrogenous compounds. Your liver releases urea into the blood which is then carried out to the kidneys. In the kidneys, urea is filtered from the blood and flushed out of the body via urine. This is a continuous process, so a small amount of urea nitrogen always remains in the blood.

In the case of a kidney or liver disease, there is a change in the amount of urea present in the blood. If your liver produces urea in an increased amount or if there is any problem in kidney functioning, there might be difficulty in filtering out the waste products from the blood, which can result in increased urea levels in the blood.

The BUN/Creatinine Ratio test helps compare the levels of blood urea nitrogen to that of creatinine in your body. Urea is a waste product that is formed in the liver when you eat protein, which is then metabolized into amino acids. This process leads to the production of ammonia that is further converted into urea. Later, the urea is passed out of your body through the urine. On the other hand, creatinine is a byproduct produced by muscles during energy production. Therefore, the more muscle you have, the more creatinine your body produces. The kidneys remove both the urea and creatinine via urine, and this test determines how well your kidneys are functioning.

The Blood Urea test measures the level of urea in the blood. Urea is a byproduct of protein metabolism. Proteins you consume in your diet are digested and converted into amino acids, which are then utilized by the body. This metabolic process produces a toxic byproduct known as ammonia. Ammonia is then rapidly converted into urea by your liver. Urea is comparatively less toxic than ammonia and is transported to the kidneys via the blood. The kidneys then filter it out through the urine. This process continues and the body keeps producing and eliminating urea, maintaining its low and steady levels in the blood.

The Sodium test measures the amount of sodium in your body. Sodium is present in all body fluids and is found in the highest concentration in the extracellular fluid. The body absorbs the required amount of sodium through dietary salts, and the kidneys eliminate the remaining sodium. The body keeps your blood sodium within a regular and steady range by following three mechanisms:

• By producing hormones that control the elimination of sodium through urine, such as natriuretic peptides and aldosterone.

• By producing hormones that prevent water loss, such as antidiuretic hormone (ADH).

• By controlling thirst (an increase in blood sodium level can make you thirsty and cause you to drink water, returning your sodium to normal).

These mechanisms regulate the amount of water and sodium in the body and control blood pressure by keeping the amount of water in check. When the sodium level in the blood changes, the water content in your body changes. These changes can be associated with dehydration, edema, and changes in blood pressure.

The Chloride test measures the amount of chloride in your body. Chloride is present in all body fluids and is found in the highest concentration in the blood and extracellular fluid (fluid present outside the cells). The body gets most of the chloride through dietary salt (sodium chloride or NaCl) and a small amount through other food items. The required amount of chloride is absorbed in the body and the excess amount is excreted by the kidneys through urine. When the chloride is combined with sodium it is mostly found in nature as salt. Chloride generally increases or decreases in direct relationship to sodium but may also change without any changes in sodium levels when there are problems with the body's pH. Usually, the normal blood chloride level remains steady with a slight fall after meals (because the stomach produces hydrochloric acid using chloride from the blood after we eat food).

The Potassium test measures the levels of potassium in your body. Potassium is one of the key electrolytes that helps in the functioning of the kidneys, heart, nerves, and muscles. It also balances the effect of sodium and helps keep your blood pressure normal. The body absorbs the required amount of potassium from the dietary sources and eliminates the remaining quantity through urine. Potassium level is typically maintained by the hormone aldosterone. Aldosterone acts on the nephrons present in the kidneys and activates the sodium-potassium pump that helps the body reabsorb sodium and excrete potassium. This aids in maintaining a regular and steady potassium level in the blood.